How golden yellow powder, an herbal medicine descended from a classical Chinese formula, helped heal a traumatic degloving wound in an Australian Shepherd.
A ten-year-old spayed female Australian Shepherd presented to the Animal Hospital of Dunedin on May 17, 2017 after suffering a traumatic degloving wound on her right rear foot. Deep tissues were exposed. After in-house laboratory values were found to be unremarkable, the dog was sedated with Dexdomitor and received an injection of Ampicillin and Rimadyl.
While the dog was under sedation, it was found that a large section of tissue was missing from the site of the injury, and full closure of the wound could not be obtained. The owner declined referral for skin grafts. Lidocaine was used to block the wound site, and the area was thoroughly cleaned and debrided. Fortunately, it appeared that the deeper tissues had been spared from damage.
The wound was closed using a simple interrupted suture pattern at the distal and proximal ends, as seen in Photo 1. The center of the wound was left open to heal by second intention, since it could not be closed.
Before the dog woke, Golden Yellow Powder was applied to a Telfa Pad which was then bandaged to the wound. The patient was sent home with a seven-day supply of Rimadyl and a 14-day supply of Cephalexin (from a local pharmacy) with the agreement that the bandage should be changed at the hospital at least every three days, with cleaning and application of Golden Yellow Powder, until the wound healed.
The first bandage change took place two days later and the wound was reported to be healing nicely. On May 23 (Photo 2), the patient was walking well, a granulation bed was forming and the tissue looked healthy. As the dog was normally highly active, the herbal formula Calm Spirit was started at this visit to quell his anxiety about being on strict rest at home. Bandage changes and applications of Golden Yellow continued on a regular basis, the wound continued to granulate in from the edges, and the dot continued to do well. The last bandage change took place on June 19 (Photo 7), about one month from the initial injury. At this time, it was decided to remove the bandage as the healing process was complete.
Golden Yellow Powder is an herbal medicine descended from Ru Yi Jin Huang San, a classical Chinese formula. Ru Yi Jin Huang San was first recorded in Wai Ke Zheng Zong, written by Chen Shi Gong during the Ming Dynasty.1 It is meant for topical use in acute inflammatory conditions accompanied by heat, swelling, pain, open wounds, and skin ulcerations, among other things.1 From a TCVM perspective, corresponding patterns are Damp-Heat, Heat Toxin, and Blood Stagnation. It is formulated in both raw powder and salve preparations.
Clinical research has shown Ru Yi Jin Huang San can be effective in treating phlebitis, skin ulcers and swelling, and that it has antibacterial activity and can increase the pain threshold.1
- The ingredient Huang Bai, when administered with Gan Cao, displays a synergistic inhibition of MRSA (Methicillin Resistant Staphylococcus Aureus), while Huang Bai alone has moderate antibacterial effects against bacteria such as Staph aureus, B-hemolytic Strep, Bacillus anthracis, Bacillus dysenteriae and Diplococcus pnuemoniae.1,2
- Huang Lian also has a broad spectrum of antibacterial activity, against coli, Pseudomonas aeruginosa, Bordatella pertussis, Leptospira, Salmonella typhi and Mycobacterium tuberculosis, among others. It also has been shown to have anti-inflammatory and antipyretic activity.2
- Jiang Huang addresses the pain and swelling with an injury and has a marked anti-inflammatory effect in rats.2
- Cang Zhu and Chen Pi have been shown to have anti-inflammatory effects.1
For further ingredients, see the table below.
This is an excellent case showing the benefits of using Golden Yellow Powder in the healing of a non-closed wound. The complete healing process was about one month in duration and required dedication and patience from the owner, dog and practitioner. The dog required no pain medication or antibiotic past the first prescriptions, and enjoyed an excellent quality of life during the healing process. Complications such as tissue necrosis, infection and poor healing were absent.
Degloving wounds can often be fraught with complications, including delayed necrosis in tissues that may have lost blood supply, requiring repeated debridement.3 This case shows the benefits of using integrative care to achieve a quality outcome for our patients.
1Ma, Aituan. Clinical Manual of Chinese Herbal Medicine, Ancient Art Press, Gaineville, Fl, 2016 300-301.
2Chen, John K, et al. Chinese Medical Herbology and Pharmacology, Art of Medicine Press, City of Industry, CA. 2004. 143,146, 623-624.
3The Merck Veterinary Manual, Ninth Ed, Merck & Co., Inc., Whitehouse Station, N.J., 2005. 1424.